Despite the rising prevalence of arthroplasty and aging population, limited data exist regarding differences in periprosthetic fracture clinical outcomes compared with native counterparts. This study compares differences in hospital treatment, morbidity, and mortality associated with periprosthetic distal femur fractures at an urban level 1 trauma center. We retrospectively reviewed all adult AO/OTA type 33 fractures (526) that presented to our institution between 2009 and 2018. In total, 54 native and 54 periprosthetic fractures were matched by age and gender. We recorded demographics, operative measures, length of stay (LOS), discharge disposition, and mortality. We used McNemar's and paired t-tests for analysis where appropriate (p < 0.05) (IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY; IBM Corp.). The average age at injury was 74 years ± 12 (native) compared with 73 years ± 12 (periprosthetic). After 1:1 matching, the groups had similar body mass index (31.01 vs. 32.98, p = 0.966 for native and periprosthetic, respectively) and mechanisms of injury with 38 native and 44 periprosthetic (p = 0.198) fractures from low-energy falls. Both groups had 51/54 fractures managed with open reduction internal fixation with a locking plate. The remaining were managed via amputation or intramedullary nail fixation. Mean operative time (144 minutes (±64) vs. 132 minutes (±62), p = 0.96) and estimated blood loss (319 mL (±362) vs. 289 mL (±231), p = 0.44) were comparable between the native and periprosthetic groups, respectively. LOS: 9 days ± 7 (native) versus 7 days ± 5 (periprosthetic, p = 0.31); discharge disposition (to skilled nursing facility/rehab): n = 47 (native) versus n = 43 (periprosthetic, p = 0.61); and mortality: n = 6 (native) versus n = 8 (periprosthetic, p = 0.55). No significant differences were observed. We found no statistical differences in morbidity and mortality in periprosthetic distal femur fractures treated over 10 years at a level 1 trauma center. Native and periprosthetic AO/OTA type 33 distal femur fractures are serious injuries with similar outcomes at a level 1 trauma center.

尽管关节置换术和人口老龄化的普及率不断上升，但与本地同行相比，关于假体周围骨折临床结果差异的数据有限。本研究比较了城市 1 级创伤中心与假体周围股骨远端骨折相关的住院治疗、发病率和死亡率的差异。我们回顾性审查了 2009 年至 2018 年间向我们机构提交的所有成人 AO/OTA 33 型骨折 (526 例)。总共有 54 例天然骨折和 54 例假体周围骨折按年龄和性别进行匹配。我们记录了人口统计数据、手术措施、住院时间 (LOS)、出院处置和死亡率。我们在适当的情况下使用 McNemar 检验和配对t检验进行分析 ( p  < 0.05)（IBM SPSS Statistics for Windows，版本 26.0。Armonk，NY；IBM Corp.）。受伤时的平均年龄为 74 岁±12 岁（自然），而受伤时的平均年龄为 73 岁±12 岁（假体周围）。经过 1:1 匹配后，各组的体重指数相似（原生体和假体周围分别为 31.01 vs. 32.98，p  = 0.966）和损伤机制，其中 38 例原生骨折和 44 例假体周围骨折（p  = 0.198）因低能量跌倒而骨折。两组中 51/54 例骨折均通过带锁定钢板的切开复位内固定术进行治疗。其余的则通过截肢或髓内钉固定进行治疗。平均手术时间（144 分钟（±64）与 132 分钟（±62），p  = 0.96）和估计失血量（319 mL（±362）与 289 mL（±231），p  = 0.44）之间具有可比性分别为原生组和假体周围组。LOS：9 天±7（天然）与 7 天±5（假体周围，p  = 0.31）；出院处置（前往专业护理机构/康复中心）：n  = 47（本地）与n  = 43（假体周围，p  = 0.61）；和死亡率：n  = 6（天然）与n  = 8（假体周围，p  = 0.55）。没有观察到显着差异。我们发现在 1 级创伤中心治疗 10 多年的假体周围股骨远端骨折的发病率和死亡率没有统计学差异。原生和假体周围 AO/OTA 33 型股骨远端骨折是严重损伤，在 1 级创伤中心具有相似的结果。